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目的探讨孕羊深低温体外循环(CPB)对胎羊温度、血流动力学和血气的影响。方法5头健康怀孕山羊常规建立CPB,转流降温、复温各1 h。监测孕羊和胎羊的温度、心率、平均动脉压、血气值。结果孕羊最低温度(17．4±1．5)℃,胎羊最低温度(24．6±1．5)℃。降温期胎羊温度始终高于孕羊温度,复温期孕羊-胎羊温差逆转,转流结束胎羊温度低于孕羊温度。降温期胎羊心率逐渐减慢,复温期不能恢复正常心率。低温转流15 min,胎羊pH值从转流开始的7．30± 0．03降到7．17±0．07(P<0．05)、PO_2从转流开始的(32．5±4．0)mmHg(1 mmHg=0．133 kPa)降到(17．5±3．0)mm Hg(P<0．05),PCO_2从转流开始的(44．8±2．2)mm Hg升到(56．8±5．1)mm Hg(P<0．05),BE值从转流开始的(-3．2±0．6)升到(-5．7±1．3)(P<0．05),此后血气值进一步恶化,复温阶段胎羊血气值也没有好转。CPB结束胎羊存活率为60％。结论孕羊深低温CPB 影响胎盘的热交换和气体交换功能,对胎羊存活不利。
Objective To investigate the effect of pregnant sheep’s cryogenic cardiopulmonary bypass (CPB) on the temperature, hemodynamics and blood gas of the fetus. Methods 5 healthy pregnant goats routinely established CPB, the transfer of cooling, rewarming 1 h. Monitoring pregnant sheep and fetal sheep temperature, heart rate, mean arterial pressure, blood gas values. Results The lowest temperature of pregnant sheep (17.4 ± 1.5) ℃, the lowest temperature of sheep (24.6 ± 1.5) ℃. The temperature of the fetus in the cooling period is always higher than that of the pregnant sheep. The temperature difference of the pregnant sheep in the reconstitution period is reversed, and the temperature of the fetus at the end of the commutation is lower than that of the pregnant sheep. Cooling rate of fetal sheep heart rate gradually slow, warm period can not return to normal heart rate. After 15 min of cold flow, the pH value of fetal sheep decreased from 7.30 ± 0.03 to 7.17 ± 0.07 (P <0.05) 4.0) mmHg (1 mmHg = 0.133 kPa) to (17.5 ± 3.0) mm Hg (P <0.05), while PCO 2 decreased from (44.8 ± 2.2) mm Hg to 56.8 ± 5.1 mm Hg (P <0.05), and BE increased from (-3.2 ± 0.6) to (-5.7 ± 1) 3) (P <0.05). After that, the blood gas level deteriorated further and the fetal blood gas level did not improve during the rewarming phase. Survival rate of sheep at CPB is 60%. Conclusions CPB of pregnant sheep affects the heat exchange and gas exchange function of the placenta, which adversely affects the survival of the sheep.